Rhonda Schwindt

Evaluation of a Theory-Based Education Program to Motivate Nursing Students to Intervene With their Seriously Mentally Ill Clients Who Use Tobacco

Tobacco dependence is a major health problem for persons with a serious mental illness (SMI). Nurses working with psychiatric clients often lack the knowledge, ability, and confidence to offer their clients meaningful, effective help to quit smoking. The purpose of this study was to evaluate the effects of a tobacco education program on the perceived competence and motivation of baccalaureate nursing students (BSN) to intervene with SMI clients who use tobacco. The education program significantly improved the competence and motivation of BSN students to deliver cessation interventions to this vulnerable population of smokers.

Effects and Durability of an SBIRT Training Curriculum for First-Year MSW Students

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based process for identification, prevention, and treatment of alcohol misuse. The purpose of this study was to examine the effects of an alcohol-focused training on first-year MSW students’ (n = 71) knowledge, attitudes, and beliefs about SBIRT. Changes in item means were assessed using repeated-measures analysis of variance (critical α = .002). Data indicated a significant and strong main effect for training; perceived competence improved immediately and remained significantly higher 30 days posttraining. Other improvements included knowing what questions to ask patients, ease making alcohol-related statements, and believing that it is rewarding to work with at-risk patients.

If you teach it, they will screen: Advanced practice nursing students’ use of screening and brief intervention in the clinical setting

BACKGROUND In the United States, approximately 30% of adults drink at risky levels or meet the criteria for harmful or dependent alcohol use. Screening, brief intervention, and referral to treatment (SBIRT) in primary care settings is indicated. This study assessed whether knowledge, attitudes, and beliefs about SBIRT, evaluated after a three-part, mixed-methods training, predicted whether 21 family nurse practitioner (FNP) students screened for alcohol use during clinical patient encounters. METHOD After training, students completed a survey and documented implementation of SBIRT during their clinical practice-specific management courses. RESULTS FNP students who reported higher levels of perceived competence in their posttraining surveys were more likely to screen for alcohol in the clinical setting. CONCLUSION Screening for alcohol misuse and identifying patients engaged in hazardous drinking meet important nurse practitioner competencies. Further research is needed to explore training programs that specifically emphasize activities to increase perceived competence, knowledge, and comfort regarding SBIRT.

Integrating Simulation into a Reflection-Centered Graduate Psychiatric/mental Health Nursing Curriculum

&NA; The purpose of this qualitative study was to explore reflections of student learning following a simulation experience integrated into a psychiatric/mental health nurse practitioner course. As the demand for clinical placement sites increases and availability of preceptors declines, students require experiences that will prepare them for competent patient care. This experiential learning activity was grounded in reflection‐centered pedagogy, utilizing standardized patients. Three main themes emerged from the data: importance of feedback, insight gained, and improved confidence. Findings suggest that simulation is a promising approach to promote the development of competencies in graduate nursing education.

Making a Case for Systematic Integration of Theory-Based Tobacco Education Into Graduate Psychiatric/Mental Health Nursing Curriculum

Tobacco use and dependence is a serious public health issue that disproportionately affects the mentally ill client population. Mental health professionals, including psychiatric/mental health advanced practice nurses (PMHAPNs), are disinclined to integrate tobacco cessation interventions into their practice, due in part, to a general lack of tobacco-related knowledge (C. Essenmacher, C. Karvonen-Gutierrez, J. Lynch-Sauer, & S. A., Duffy, 2008; A. J. Molina, T. Fernandez, D. Fernandez, M. Delgado, S. de Abajo, & V. Martin, 2012; L. Sarna, L. L. Danao, S. Chan, S. Shin, L. Baldago, E. Endo, & M. E. Wewers, 2006); D. Sharp, S. Blaakman, R. Cole, & J. Evinger, 2009). This paper provides an in-depth literature review of tobacco education in nursing curricula and proposes the systematic integration of theory-based tobacco content into psychiatric/mental health graduate nursing programs.

‘Asking’ but Not ‘Screening’: Assessing Physicians’ and Nurses’ Substance-Related Clinical Behaviors

ABSTRACT Background: Screening, brief intervention, and referral to treatment (SBIRT) is a promising public health approach for problematic substance use. A core component of SBIRT is the use of formal screening tools to categorize a patients likely level of risk in order to provide an appropriately-matched service. Training in formal screening is included in many SBIRT training programs, but infrequently is emphasized. Objectives: To assess pre-training levels of SBIRT-related clinical behaviors, including screening, this study examined a secondary dataset collected from internal medicine residents and graduate nurse practitioner students. Methods: Learners (n = 117) completed 13 self-report items assessing use of SBIRT-related behaviors. Researchers used exploratory factor analysis to identify underlying concepts in the questionnaire, then used mixed ANOVA to compare mean frequency of utilization of each factor (asking, screening, and intervening) by academic program. Results: Learners reported asking about substance use frequently, intervening some of the time, and infrequently using formal screening tools. Interaction and between-academic-program effects were significant but small. Conclusions: Prior to SBIRT training, most clinical practitioners reported asking patients about substance use, but few reported regularly using formal substance use screening tools. This may have implications for the importance of SBIRT training as part of curricular work, and for the internal content foci of SBIRT curricula.

Training future clinicians: An interprofessional approach to treating tobacco use and dependence

ABSTRACT The high prevalence of smoking among persons with mental illness and co-occurring substance use disorders has not changed in the past decade despite a decline in smoking among the general population. Interprofessional collaborative care offers clinicians the opportunity to engage their patients in tobacco cessation treatment that is coordinated and comprehensive. Investigators applied a 1-group, pre/post-test design with qualitative and quantitative descriptive analyses to estimate the impact of an interprofessional tobacco education program on perceived self-efficacy and self-reported counseling abilities of graduate nursing, social work, and pharmacy (PharmD) students (N = 36; nursing, n = 13, n = 9 PharmD, n = 14 social work) to treat tobacco dependence among this subpopulation of smokers, and to assess their perceptions of interprofessional education. All participants completed a 2-h web-based module, a 3-h classroom training, a simulation with a standardized patient, and a group audio-recorded debriefing session with faculty. Emergent themes from qualitative analyses were valuing simulations, demystifying disciplines, reflecting on and critiquing practice, and lessons learned. Participants’ perceived self-efficacy, self-rated counseling ability, intention to ask about tobacco use, and intention to provide counseling for tobacco cessation increased significantly. Teaching students an interprofessional team approach appears to be effective in enhancing counseling abilities and self-efficacy and may positively influence health professions students’ perceptions of interprofessional education. Larger studies are recommended to validate the results of this pilot study.

Impact of Tobacco Quitlines on Smoking Cessation in Persons With Mental Illness: A Systematic Review

Persons with mental illness smoke at rates two to four times higher than do persons without mental illness and comprise 30.9% of the U.S. tobacco market. Given the prevalence of mental illness and the known detrimental effects of tobacco, concerted efforts are needed to promote the use of evidence-based treatment options. We conducted a systematic review of studies that examined the impact of tobacco quitline interventions in this population. Results revealed an overall positive impact of cessation services delivered via a tobacco quitline. More research is needed to determine intervention components and patient characteristics that are associated with cessation success.